Early days of Obamacare bring trickle, not flood, of patients

NEW YORK Sat Jan 4, 2014 12:47pm EST

Maria Franco (R) explains health insurance to Violet Lucas-Barajas, 28, at an event to inform people about the Affordable Care Act and donate turkeys to 5,000 needy families, in Los Angeles, California, November 25, 2013. REUTERS/Lucy Nicholson

Maria Franco (R) explains health insurance to Violet Lucas-Barajas, 28, at an event to inform people about the Affordable Care Act and donate turkeys to 5,000 needy families, in Los Angeles, California, November 25, 2013.

Credit: Reuters/Lucy Nicholson

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NEW YORK (Reuters) - U.S. medical providers are seeing only a trickle of patients newly insured under President Barack Obama's healthcare law, as insurers, hospitals and doctors try to work out any hitches in coverage.

More than 2 million people have signed up for new private health plans that took effect on Wednesday under the Affordable Care Act, popularly known as Obamacare. While some of those consumers were already lining up doctor visits last month, early reports from providers and an online medical booking service show the demand for care has been modest so far.

Within the Obama administration, officials fear a surge of patients in the coming weeks could spotlight cases where consumers who signed up for insurance can't immediately get care due to technical failures on the government's HealthCare.gov enrollment website.

Already on Friday, Senate Republicans opposed to the law seized on scattered media reports of a handful of people having difficulty confirming their new insurance policies, feeding into a narrative of Obamacare's harms that is expected to intensify ahead of Congressional elections in November.

Central Ohio Primary Care, a 250-physician practice, is holding off on filing claims for patients who say they bought plans through the HealthCare.gov exchange, said Chief Executive Officer Dr. William Wulf.

The delay will allow insurers more time to confirm membership information and avert any erroneous claim denials, Wulf said.

Such a grace period "surely is not desirable long term," he said, but the number of patients with Obamacare plans has so far been low and represents only a small fraction of the practice's patients.

"What we're doing is we're seeing the patients, trusting they are in fact going to pay for insurance and just not sending a bill yet," Wulf said.

Contrary to fears that Obamacare enrollees would be sicker than other Americans, with serious and expensive pent-up medical needs, so far they are not much different from other Americans, according to data from ZocDoc, a six-year-old closely held company that allows patients to find a doctor who accepts their insurance and make an appointment online.

Obamacare consumers "started booking appointments the last two weeks of December for January appointments," said ZocDoc founder and Chief Operating Officer Dr. Oliver Kharraz. "The vast majority of these were for preventive care, not acute care where people indicated they had an existing illness, which accounted for only 7 percent of searches."

That mirrors the behavior of ZocDoc's previously insured users. ZocDoc says the site gets just over 5 million unique visitors each month who are searching doctors' ratings and reviews as well as making appointments.

As many as 7 million people are expected to sign up for the new health plans, which include government subsidies for lower-income households, by the time 2014 enrollment ends on March 31.


Of course, some newly insured people were anxious to get care almost as soon as the last strains of Auld Lang Syne petered out.

One customer of North Shore-LIJ CareConnect, a new insurer selling plans on the New York State of Health marketplace, went to its customer center last month, paid cash for a policy, "and asked if he could now schedule his son's gastric bypass," said Chief Executive Officer Alan Murray.

In the case of another CareConnect customer, last month her doctor arranged for her to have surgery for recently diagnosed endometrial cancer as soon as possible. The insurer approved it in December, before her coverage even kicked in, the surgery was successfully performed on January 2, and the woman was discharged from the hospital on Friday.

Insurers also heard from unusually high numbers of new customers anxious to confirm their coverage.

On January 1, Philadelphia-based Independence Blue Cross received eight times as many calls as a typical New Year's Day from consumers most commonly seeking to confirm that they were indeed covered, said Brian Lobley, senior vice president of marketing and consumer business.

"We haven't seen any systemic issues" of Independence's newest members having trouble confirming their policies, he said.

Because medical practices often do not file insurance claims daily, he added, it is too early to draw any conclusions about use of medical services with the new plans.

On ZocDoc, people with Obamacare insurance searched most frequently for primary care physicians, accounting for more than half of all searches, said Kharraz, followed by obstetricians/gynecologists and dermatologists. That is identical to the most-searched-for categories for people with non-Obamacare coverage, he said.

Hospitals expect Obamacare to bring them more paying patients and reduce the amount of uncompensated care they provide, but have not seen a surge yet.

"We continue to expect an uptick in volume, but we don't think it's anything beyond what most hospitals are prepared to handle," said Jeff Goldman, vice president of coverage policy for the American Hospital Association

Pharmacists are not reporting a surge in demand either. "At this time, activity is fairly typical of what we experience each year when insurance changes take effect," said Walgreen Co spokeswoman Markeisha Marshall. "Nonetheless, we anticipate a surge of activity next week."

(Editing by Michele Gershberg and Lisa Shumaker)

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Comments (32)
Bighammerman wrote:
All of Obama’s new taxes are set to kick in as part of the ACA, Bye Bye middle class! Hope all of you like what you voted for.

Jan 04, 2014 10:10am EST  --  Report as abuse
Harry079 wrote:
Yesterday I called the Help Center for the tenth time since I completed my application and created an account on November 30.

Every Help Center Representative I talked to since then has been very polite and apologetic for the glitch that believes for some reason that I am currently INCACERATED.

After many hours on the phone working with a different Help Center Represenative each time they were able to push my ENROLLMENT through to the very last step before actually getting coverage.

Before yesterday the last Representative I talked to suggested I upload a testimony or affidavid stating that I was not now or ever have been INCARCERATED.

I did what she requested on December 31 and called yesterday to see if they received and accepted that letter. When I called yesterday I asked to speak to a Resolution Specialist and the Representative tranfered me to one.

The Resolution is:

1. I had to make an appointment with the Chief of Policeof my city and get a Noterized Statement that I am not currently or even recently been INCARCERATED.

2. I have to make a copy of this letter and sent it Registered Mail to the Help Center in London Kentucky.

The Resolution Specialist did push my enrollment in the plan that best fit my wife and I through and as soon as I can make the first payment my coverage will start.

If I can’t get this INCARCERATION glitch fixed by March 1st my coverage will be cancelled and I could probably go to PRISON for real.

I don’t know how many other people have had this same problem but I do know there are others out there. I feel that like the last 5 weeks has been spent arguing with a brick wall. The wall knows I’m not in prison but can’t tell from which side of the wall I’m calling from.

Jan 04, 2014 10:44am EST  --  Report as abuse
basha10 wrote:
Obamacare is a seriously failed system. I’ll tell you why. A friend of mine landed himself in the hospital in Dallas. No insurance. He was taken by ambulance. Pretty busted up. Broken foot, broken elbow, broken shoulder, 3 broken ribs, one of which punctured his lung and a fractured back. The kept him in the hospital FOUR days and threw him out. They refused to give him any pain medication and said he needed surgery. He’s broken inside and out at his mother in law’s place in Ft. Worth. Obamacare was created by Obama because he was tired of seeing people turned away for care. Unbelievable. Let’s hope my friend has a miracle. This shouldn’t be.

Jan 04, 2014 10:51am EST  --  Report as abuse
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